TY - JOUR
T1 - Achieving Weight Loss and Hypertension Control among Obese Adults
T2 - A US Multidisciplinary Group Practice Observational Study
AU - Ho, Aaron K.
AU - Bartels, Christie M.
AU - Thorpe, Carolyn T.
AU - Pandhi, Nancy
AU - Smith, Maureen A.
AU - Johnson, Heather M.
N1 - Publisher Copyright:
© 2016 American Journal of Hypertension, Ltd. All rights reserved.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - BACKGROUND: Among adults with hypertension, obesity independently contributes to cardiovascular disease. Weight loss and hypertension control are critical to reduce cardiovascular events. The purpose of this study was to evaluate rates and predictors of achieving weight loss among adults who achieved hypertension control within 1 year of developing incident hypertension. METHODS: Retrospective electronic health record analysis was performed of ≥18 year olds with a body mass index ≥30.0kg/m2, who received regular primary care from 2008 to 2011 and achieved hypertension control. Exclusions were less than 60 days follow-up, prior hypertension diagnosis, prior antihypertensive prescription, or pregnancy. The primary outcome was clinically significant weight loss (≥5kg); the secondary outcome was modest (2.0-4.9kg) weight loss. Multinomial logistic regression identified predictors of achieving weight loss (≥5 or 2.0-4.9kg) compared to no significant weight loss (<2kg). RESULTS: Of the 2,906 obese patients who achieved hypertension control, 72% (n = 2,089) did not achieve at least 2.0kg weight loss. Overall, 12% (n = 351) achieved ≥5kg weight loss. Young adults (18-39 year olds; odds ratio (OR): 2.47, 95% confidence interval (CI): 1.63-3.47), middle-aged adults (40-59 year olds; OR: 2.32, 95% CI: 1.59-3.37), and patients prescribed antihypertensive medication (OR: 1.37, 95% CI: 1.07-1.76) were more likely to achieve clinically significant weight loss and hypertension control. Age remained a significant predictor for 2.0-4.9kg weight loss. CONCLUSIONS: Despite achieving hypertension control, the majority of obese patients did not achieve clinically significant weight loss. Effective weight loss interventions with dedicated hypertension treatment are needed to decrease cardiovascular events in this high-risk population.
AB - BACKGROUND: Among adults with hypertension, obesity independently contributes to cardiovascular disease. Weight loss and hypertension control are critical to reduce cardiovascular events. The purpose of this study was to evaluate rates and predictors of achieving weight loss among adults who achieved hypertension control within 1 year of developing incident hypertension. METHODS: Retrospective electronic health record analysis was performed of ≥18 year olds with a body mass index ≥30.0kg/m2, who received regular primary care from 2008 to 2011 and achieved hypertension control. Exclusions were less than 60 days follow-up, prior hypertension diagnosis, prior antihypertensive prescription, or pregnancy. The primary outcome was clinically significant weight loss (≥5kg); the secondary outcome was modest (2.0-4.9kg) weight loss. Multinomial logistic regression identified predictors of achieving weight loss (≥5 or 2.0-4.9kg) compared to no significant weight loss (<2kg). RESULTS: Of the 2,906 obese patients who achieved hypertension control, 72% (n = 2,089) did not achieve at least 2.0kg weight loss. Overall, 12% (n = 351) achieved ≥5kg weight loss. Young adults (18-39 year olds; odds ratio (OR): 2.47, 95% confidence interval (CI): 1.63-3.47), middle-aged adults (40-59 year olds; OR: 2.32, 95% CI: 1.59-3.37), and patients prescribed antihypertensive medication (OR: 1.37, 95% CI: 1.07-1.76) were more likely to achieve clinically significant weight loss and hypertension control. Age remained a significant predictor for 2.0-4.9kg weight loss. CONCLUSIONS: Despite achieving hypertension control, the majority of obese patients did not achieve clinically significant weight loss. Effective weight loss interventions with dedicated hypertension treatment are needed to decrease cardiovascular events in this high-risk population.
KW - blood pressure
KW - hypertension
KW - obesity
KW - primary care
KW - weight management
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U2 - 10.1093/ajh/hpw020
DO - 10.1093/ajh/hpw020
M3 - Article
C2 - 26917445
AN - SCOPUS:84983001958
SN - 0895-7061
VL - 29
SP - 984
EP - 991
JO - American journal of hypertension
JF - American journal of hypertension
IS - 8
ER -